Our Latest Perspectives Posts

The Black Friday Shoppers’ Health and Safety Survival Guide

Determined to brave the traffic, crowds and general madness of Black Friday, many shoppers strike out to take advantage of deep discounts on holiday goods. We offer tips to help ensure shoppers return home from these shopping adventures safely and in good health.

Safety First

  • As exciting as it is to get to the sales early, don’t compromise safety when driving or walking to the shops. Obey traffic and pedestrian rules—arrive alive and unharmed. Exercise extra caution driving and walking in packed parking lots.
  • Reduce your chances of being caught and injured in a stampede at “door buster” sales. It’s better to hang back or off to the side than to risk injury in a rushing crowd.

Be a Healthy Shopper

  • Be mindful that frequently touched surfaces such as door handles and electronic key pads are drop off and pick-up points for germs. Keep your hands away from your face while shopping, and make frequent use of portable hand sanitizer.
  • Use your knuckle instead of the pad of your finger to depress elevator keys or automatic door openers.
  • Using a public restroom? Use a clean tissue or paper towel to act as a barrier between you and the restroom door handle as you enter and exit. Wash your hands thoroughly after using the restroom.
  • Cough and sneeze into a tissue or into the crook of your elbow to prevent germs spreading to your fellow shoppers.
  • Did you remember to get a flu shot? The flu vaccine is recommended for all people over the age of six months, with rare exception. It’s not too late to get one now, but next year remember, “Vaccine by Halloween” for the timeliest protection against the seasonal flu. See your doctor if you have questions about the flu vaccine.
  • Stay home on Black Friday if you are sick. Considering how many people you could potentially infect in mobbed shopping centers, online bargain shopping just might be the kinder, gentler option when you are under the weather. And remember: Cyber Monday is only three days after Black Friday.
  • Recognizing that some of the best sales begin very early in the day, consider putting your egg nog down on Thanksgiving night and getting a good night’s sleep.

Happy Bargain Hunting!

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Holiday Food Safety and the Foodkeeper App

A beautifully arranged holiday dinner table is a feast for the senses. Occasionally, however, festive fare that looks perfectly delectable can sicken unsuspecting diners. There are many ways in which the “perfect” holiday dinner can go horribly wrong. Fortunately, most foodborne illness can be avoided when cooks maintain and apply a keen awareness of the basics of food safety. Add to that a new “app” issued by the US Department of Agriculture (USDA), and safe food storage and preparation can be a snap this holiday season.

Food Safety Basics

“Clean” starts with the cooks washing their hands with soap and warm water before and after handling any food item (not just raw animal or vegetable products). Food preparation surfaces, such as cutting boards and countertops, should be thoroughly washed with soap and hot water, followed by sanitizing with a solution of one tablespoon of unscented, liquid chlorine bleach per gallon of water. Air-dry.

“Separate” foods so that juices from raw meats, poultry and seafood, which can contain harmful bacteria, do not contact ready-to-eat food. Place raw meats, poultry and seafood in plastic bags in the refrigerator to prevent their juices from dripping onto other food. To lower the risk of accidental dripping, place those plastic bags on the lowest shelves of the refrigerator.

Designate one cutting board for raw fruits and vegetables and another for raw meats, poultry and seafood.

Never place cooked food back on the same plate that previously held raw food unless the plate has first been washed in hot, soapy water.

“Cook” foods to safe minimum internal temperatures to destroy harmful bacteria. The food thermometer should be placed in the thickest part of the food, away from bone, fat or gristle. According to the Foodsafety.gov website, poultry, including chicken, turkey, duck and goose, should be cooked to a minimum internal temperature of 165 degrees F.

“Chill” foods that should be refrigerated at 40 degrees F or below. Defrost frozen foods in the refrigerator, microwave or cold water. Do not leave food at room temperature for more than 2 hours (or 1 hour when the air temperature is 90 degrees F or more). Meat defrosted in the refrigerator is safe to re-freeze before or after cooking. Foods defrosted in the microwave or cold water must be cooked before freezing. Store eggs in the refrigerator in their original carton and use within three to five weeks.

An App for the Kitchen

The new “Foodkeeper” app, developed by the USDA’s Food Safety and Inspection Service, with Cornell University and the Food Marketing Institute, was designed to help consumers understand and optimize food and beverage storage. The app is available for Android and Apple devices.

Here is a sampling of the type of information available through the Foodkeeper app:

  • Cooked poultry dishes (e.g., turkey and chicken) last 3 to 4 days when stored in the refrigerator and 4 to 6 months if stored frozen. Poultry should be cooked in an oven to a safe minimum temperature of 165 degrees F.
  • Fresh potatoes last 1 to 2 months in the pantry (the recommended storage method for whole potatoes) and 1 to 2 weeks in the refrigerator (refrigerating potatoes is not recommended as potatoes may darken during cooking and develop an unpleasantly sweet taste1 )
  • Bagged greens, such as spinach and lettuce, last 3 to 5 days after the date on the bag when stored in the refrigerator, and 2 days if refrigerated after opening. Freezing bagged greens is not recommended.
  • Hard cheeses such as cheddar, Swiss and block parmesan last 6 months in the refrigerator before opening, and 3 to 4 weeks in the refrigerator after opening, but 6 months if stored frozen.
  • Ready to Bake Pie Crust should be used by the date indicated on the package when stored in the refrigerator, but can last up to 2 months if stored in the freezer.
  • Whipped, sweetened cream lasts 1 day when stored in the refrigerator and 1 to 2 months if stored frozen.
  • Fruit juice and punch in cartons last 3 weeks in the pantry, 7 to 12 days in the pantry if stored after opening, and 8 to 12 days if refrigerated after opening.

Keep the four food safety basics in mind as you gear up for holiday cooking. And remember the Foodkeeper app, which can help you decide on the usability of ingredients. Finally, trust your instincts: If a food or drink looks suspect, follow the old adage, “When in doubt, throw it out.”

Here’s wishing you a happy and safe Holiday Season!

Linda F. Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality and Health Council.

Click here to download this article.

1 The recommendation not to refrigerate potatoes comes from the United States Potato Board.



Five Tips for Getting through Flu Season

The 2016–2017 flu season is off to a slow start, but the Centers for Disease Control and Prevention (CDC) predicts an uptick in flu activity in the coming weeks and months. Here are some tips to help prepare and inform you as flu appears in your community:
Flu Season Ahead

  1. Get a Flu Shot: CDC recommends a flu shot for everyone six months old and older. Flu vaccines protect against the three or four flu viruses most likely to spread in a given season. What segments of the population are most vulnerable to flu-related complications? The very young, people aged 65 and older, pregnant women, and people with chronic health conditions such as asthma, diabetes or heart and lung disease are most at risk for complications.

To help avoid spreading the flu to those in their care, health care workers and people who care for vulnerable populations, including families of babies under the age of six months, should be sure to get their flu shot.

Maximum immune system protection against the flu takes about two weeks from the time of vaccination. CDC advises people to get their flu shots each year by the end of October. Some health departments are proclaiming: “Vaccine before Halloween!”1 This year’s breaking news on flu is that the nasal spray is not recommended by CDC because its effectiveness is in question.

  1. Wash Your Hands: Washing your hands frequently and thoroughly is one of the most important ways to elude the flu. Flu virus particles are very good at hitching a ride from contaminated surfaces (door knobs and hand rails, for example)—where they gather like airline passengers at a departure gate—to your hands and then for the “flight” to your eyes, nose and mouth. Viruses can only spread by infecting new hosts, and they appreciate not being washed down the drain. Give them the slip with thorough hand washing (use alcohol-based hand rub if soap and water are unavailable), and keep your hands away from your face.
  1. Disinfect Frequently Touched Surfaces: Destroy flu virus particles where they lurk to lower your odds of picking them up and becoming infected. Clean surfaces first with detergent and water and then sanitize using two teaspoons of high strength household bleach (8.25%) per gallon of water. Alternatively, wipe down surfaces with disposable pre-moistened wipes containing chlorine bleach.
  1. Maintain a Healthy Lifestyle: Get adequate sleep, maintain a healthy diet, stay hydrated and exercise regularly to keep your immune system on alert against flu and other infections.
  1. Be Kind to Others: If you do get the flu, stay home and limit your contact with others. Cover your coughs and sneezes with a disposable tissue and wash your hands after using tissues. Tissues not available? Cough or sneeze into your elbow to help prevent projecting thousands of infected mucous droplets into the air that others breathe! Finally, keep your distance from those who appear to have flu symptoms but have opted to be out and about anyway.

Not sure if you have the flu or a cold? Use this chart to help you decide. For more information on the seasonal flu, please see this CDC website.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

Click here to download this article.

1 See, for example, this WJHG.com video.



Norovirus and Chlorine Bleach: The Perfect Pathogen Meets its Match

Colorized transmission electron micrograph of norovirus particles

Colorized transmission electron micrograph of norovirus particles

Courtesy of CDC/ Charles D. Humphrey


Is there such a thing as a “perfect” human pathogen? If by perfect we mean a disease-causing microorganism that is highly contagious; quickly and profusely shed in the environment by its hosts; and able to evolve rapidly to both avoid widespread human immunity and ensure a large pool of susceptible hosts, then norovirus comes very close. Norovirus expert Dr. Aron Hall of the Centers for Disease Control and Prevention’s (CDC’s) Division of Viral Diseases cleverly entertained the notion that noroviruses could be the perfect human pathogens in a 2012 editorial commentary.1

Notorious Norovirus

Sometimes referred to as “the stomach bug,” and infamous for spreading through cruise ships, norovirus is responsible for some 19-21 million cases of gastrointestinal illness in the US annually.2 The very young, the very old and the immunocompromised are especially vulnerable to norovirus. It is the most common cause of foodborne illness in the US—responsible for at least 50,000 hospitalizations and between 570 and 800 deaths annually.3 But norovirus respects no borders. It is a global player. Found in both developed and developing countries, it is the main cause of half of all gastroenteritis outbreaks worldwide. A 2016 analysis4 estimated the virus’ global economic burden at $60 billion, the largest share of which ($56 billion) is lost productivity.

Means of Transmission

Norovirus is spread in three main ways: (1) close personal contact with an infected individual; (2) ingesting contaminated food or water; and (3) contact with contaminated surfaces. Norovirus can be transmitted by ingesting food contaminated at the source (e.g., fruits and vegetables) or by infected food handlers. (Food handlers who return to work sooner than 48 hours after they no longer have symptoms can still spread norovirus.5 ) Norovirus has remarkable staying power on environmental surfaces where it can persist for up to two weeks. It can survive freezing and withstand heating to 140 degrees. To destroy norovirus in drinking water, CDC recommends6 bringing water to a rolling boil (212 degrees Fahrenheit) for one minute. Astonishingly, only 18 norovirus particles are required to infect a human host. For perspective, there are billions of particles in the stool and vomit of infected individuals.

Outsmarting Norovirus

Efforts to develop a vaccine for norovirus are still in their infancy,7 so proper hygiene and surface disinfection practices must be employed to control the spread of the perfect pathogen. People infected with norovirus are advised to limit their contact with others for at least two days after symptoms have ended. Disinfecting surfaces contaminated with the persistent norovirus can go a long way to curtailing outbreaks. Properly prepared chlorine bleach solutions (see below) destroy norovirus on surfaces. Simply cleaning surfaces with soap and water or other cleaning product can actually spread virus particles. In the City of Albuquerque, for example, restaurant staff are encouraged to switch from quaternary ammonium disinfectants to chlorine bleach disinfectants when a norovirus outbreak occurs.8

Communicating a Disinfection Strategy

In 2012, the Water Quality and Health Council participated in a partnership with public health experts, including the New Jersey Somerset County Department of Health, the CDC, the National Environmental Health Association and others, to develop a series of downloadable posters featuring directions for preparing bleach solutions to destroy noroviruses on surfaces. For example, the posters include detailed directions on how to clean and disinfect an area affected by a vomiting or diarrhea incident. Posters are available in English, Spanish and French and can be found at http://www.disinfect-for-health.org/tools-reduce-spread-norovirus.

So when it comes to combatting the nearly perfect pathogen norovirus, remember:

  • the right way to wash your hands;
  • do not prepare food or care for others when you are sick;
  • wash fruits and vegetables and cook seafood thoroughly;
  • clean and disinfect contaminated surfaces using chlorine bleach or other disinfectant registered as effective against norovirus by the EPA; and
  • launder clothes thoroughly.

Linda F. Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality and Health Council.

Click here to download this article.

1 Hall, A.J. (2012). Noroviruses: The Perfect Human Pathogens? Journal of Infectious Diseases, 205: 1622-1624. http://jid.oxfordjournals.org/content/205/11/1622.full.

2 CDC (2015). Norovirus: U.S. Trends and Outbreaks, http://www.cdc.gov/norovirus/trends-outbreaks.html.

3 CDC (2015). Prevent the Spread of Norovirus, http://www.cdc.gov/features/norovirus/.

4 Bartsch, S.M., Lopman, B.A., Ozawa, S., Hall, A.J., and Lee, B.Y. (2016). Global Economic Burden of Norovirus Gastroenteritis, PLOS ONE, DOI:10.1371/journal.pone.0151219. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151219.

5 CDC (2014). Norovirus and Working with Food, http://www.cdc.gov/norovirus/food-handlers/work-with-food.html.

6 CDC (2015). Noroviruses and Drinking Water from Private Wells, http://www.cdc.gov/healthywater/drinking/private/wells/disease/norovirus.html.

7 CDC (205). Making a Norovirus Vaccine a Reality, https://blogs.cdc.gov/publichealthmatters/2015/03/making-a-norovirus-vaccine-a-reality/.

8 “Norovirus Kitchen/Dining Room Response Procedures, City of Albuquerque Environmental Health Department handout at 4th Annual Norovirus Conference, August 4, 2016.



The Right Way to Wash Your Hands
Written by Barbara Soule, RN, MPA, CIC, FSAHEA

Wash your hands! The parental command echoes in my memory. It is also the public health message we hear most often when the subject is preventing the spread of infectious illness. Hand washing may be one of the easiest things we can do to ward off sickness, but the casual observer in any public restroom can attest to the slap-dash ritual practiced by many. Running water over the hands for a few seconds may be better than nothing, but consciously washing hands correctly is a learned behavior that can pay dividends.

The “Why” of Handwashing

The simple fact is that washing hands removes germs that can make you and others sick. Human hands, which perform countless useful activities, are also the prime vehicles for moving germs from person to person.  As the Centers for Disease Control and Prevention (CDC) website notes, people can infect themselves by touching their eyes, nose and mouth.  Germ-laden hands can make others sick when they prepare food or drinks. And frequently touched surfaces, such as hand rails and publicly used electronic touch pads, are essentially “drop-off” and “pick-up” points for the germ du jour.

According to CDC, teaching people about handwashing benefits the community in which they live. Studies cited by CDC1 show handwashing reduces:

  • The number of people who get sick with diarrhea by 31%
  • Diarrheal illness in people with weakened immune systems by 58%
  • Respiratory illnesses in the general population by 16-21%

The “How” of Handwashing

A downloadable World Health Organization poster recommends following the steps below to wash your hands correctly.  Practice (and review the chart) until the steps become routine.  You will know you have washed long enough if you can hum the “Happy Birthday” song twice.  By the way, “handrub” is another way of denoting “hand sanitizer.”

At a recent public health conference I attended, a presenter guided the audience through a lively “dry run” handwashing exercise from their seats in the auditorium. Shortly afterwards, during a scheduled break in the agenda, the restrooms filled with people who had been through the exercise. It was obvious that attendees at the sinks were self-consciously attempting to replicate the handwashing steps properly. No one wanted to be that slap-dash hand washer, and a few commented that they were trying hard to get it right. I like to think that those conference attendees are now modeling great handwashing for others, spreading a good habit, and—most importantly—not spreading germs!

You might want to try it yourself and teach it to your children to instill good habits early.

Barbara M. Soule, R.N. MPA, CIC, FSHEA, FAPIC is an Infection Preventionist and a member of the Water Quality & Health Council.

Click here to download this article.

Studies cited by CDC on its Handwashing:  Clean Hands Save Lives website include:

  1.  Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev. 2008;1:CD004265.
  2. Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis.Am J Public Health. 2008;98(8):1372-81.
  3. Huang DB, Zhou J. Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study. J Med Microbiol. 2007;56(5):659-63.
  4. Rabie T and Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic review.Trop Med Int Health. 2006 Mar;11(3):258-67.

Are You Ready for an Emergency?

Earthquakes, hurricanes, tornadoes, floods, wildfires, pandemics1 , disease outbreaks, terrorist attacks… We may not like to think about the disasters that can befall us, but these potential events warrant our preparedness. September is National Preparedness Month, and a new infographic—The Power of Preparedness—from the Centers for Disease Control and Prevention (CDC) indicates that over 60 percent of Americans do not have an emergency plan that they have discussed with their household. Are you in that camp? According to the 2014 Federal Emergency Management Agency report, “Preparedness in America”, the percentage of people taking recommended preparedness actions in 2011 remains largely unchanged since 2007.

Taking the First Steps

Where you live determines the type of emergency you may be most at risk of experiencing. If you live in a coastal area, your greatest risk could be hurricanes. Flooding may be a serious risk if you live near water, in a flood zone, for example. You may live in a tectonically active area, in which case earthquakes are a concern. Residents in or near forested areas subject to drought may count wildfires among their greatest risks. Do you live in a metropolitan area and have close contact with many people on a daily basis in your commute to work or as part of your job? Diseases can spread quickly among people in close contact. Unfortunately, by their nature, terrorist attacks are random and unpredictable.

Once you have determined your greatest risk factors, preparedness activities become clearer. That said, every household could benefit by storing and regularly updating:

  • Water and food to last each person at least 3 days (more is likely appropriate for many emergencies; for example, a pandemic may require 6-8 weeks of supplies).
  • Fuel for cooking, e.g., propane or charcoal.
  • Medications and first aid supplies for each person to last at least 3 days (include prescription medications and over-the-counter medications for treating fever, flu, colds, etc.).
  • Unscented chlorine bleach or appropriate water treatment tablets for preparing safe drinking water after stored water supplies have been depleted.
  • Flashlights and radios (and the appropriate batteries to power them unless they are solar-powered or operated by a hand-crank).
  • Candles and matches.
  • Emergency cash (Think: What if ATMs were inoperable?).
  • A family plan previously discussed with family members including routes to take/not take to get home and meeting sites in case getting home is not possible.
  • A pet plan which includes identification tags, food, water, and a safe place for them in the event of an emergency.

Customizing Your Emergency Plan

Build on the basic recommendations above with your unique circumstances in mind.

  • If you take life-sustaining prescription medication, discuss with your doctor the possibility of storing an emergency supply of medication in your home.
  • If you anticipate that a forest fire or earthquake could force you to leave your home, have an emergency “go bag” ready that contains at least one change of clothing, medicines, personal hygiene and other items you will likely need to survive away from home, such as your cell phone charger.
  • A face mask can help protect you during dust storms and from volcanic ash or ash from wildfires.
  • Is your only means of transportation from your community by personal vehicle? Keep your vehicle in good repair and its gas tank at least 50 percent full. On the other hand, if it is unlikely that you will have to evacuate, but you know that losing power is a real risk, you might want to invest in a portable generator and plan how you will safely store propane or gasoline.
  • Long, insulated underwear is essential in extremely cold weather disasters when gas and electricity go out for extended periods of time.
  • How do elderly and incapacitated neighbors and relatives fit into your emergency plans?
  • How about a bad flu season? The Water Quality & Health Council developed “Dr. Ralph’s Flu Preparedness Closet” to list the items needed to stay healthy and secure during a pandemic flu outbreak.
Emergency Water

Water is one of the “non-negotiables” of our daily survival. According to www.ready.gov/water, each person in a household requires one gallon of safe water per day for drinking and sanitation.

Either purchase commercially bottled water to store, or prepare your own containers of water using food grade water storage containers (visit surplus or camping supply stores or their websites). Alternatively, use 2-liter plastic drink bottles that are thoroughly cleaned.

Sanitize plastic drink bottles with a solution made by adding 1 teaspoon of unscented chlorine bleach to one quart of water. Rinse well and fill each 2- liter bottle with tap water. If your tap water is treated by a water utility, nothing else is required. If the tap water comes from a well or other untreated source, add 2 drops of non-scented chlorine bleach to the water. Let the water stand for at least 30 minutes before using. Tightly close each bottle (don’t touch the inside of the cap), write the date on a label and store in a cool, dark place. Water that has not been commercially bottled should be replaced every 6 months.

One easy way to get started on the path to preparedness is to download the FEMA App to your smart phone. You will receive weather alerts and be able to access critical information in the event of an emergency, including the locations of emergency shelters. Our hope this National Preparedness Month is that more Americans will see preparedness as a worthwhile and potentially life-saving activity.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

Click here to download this article.

1 A pandemic is a widespread disease outbreak, affecting large areas, such as an entire country, continent, or even the entire world.



What Are Zoonotic Diseases?
Written by Water Quality & Health Council

If you guessed that ZOOnotic diseases have something to do with animals, you are right.  According to the Centers for Disease Control and Prevention (CDC), a zoonotic disease is one that can spread between animals and humans under natural conditions—such as in homes, on farms, and at county fairs and petting zoos—and can be caused by viruses, bacteria, parasites and fungi.  Ironically, animals that can transmit zoonotic pathogens (disease-causing germs) to people often have no symptoms of disease and simply act as carriers.

Zoonotic, Emerging, and Waterborne Diseases

Zoonotic diseases are also very common:  At least six out of every 10 infectious diseases in humans are thought to be spread from animals.  Wildlife serves as a “reservoir” for many diseases common to domestic animals and humans.  Moreover, zoonotic pathogens are closely tied to so-called emerging (or reemerging) infectious diseases, and up to 75% of emerging pathogens are thought to be of zoonotic origin, including Ebola virus disease and Lassa fever.

Of course, people all over the world enjoy and work with animals on a daily basis.  But we also encounter very small animals unintentionally, such as ticks, fleas and mosquitoes (called disease “vectors”), which can transmit a wide variety of zoonotic diseases of tremendous global health importance.  In addition to Zika virus, mosquitoes can transmit West Nile virus, Dengue, malaria and chikungunya, and thrive in urban neighborhoods with standing, untreated water such as neglected or abandoned swimming pools.

Not surprisingly, many waterborne diseases, including outbreaks, result from ingesting zoonotic pathogens—whether of human or animal origin.  Well-known zoonotic diseases include cryptosporidiosis and giardiasis, particularly because both are caused by enteric protozoan parasites that are resistant to chlorination.  Cryptosporidium was responsible for the largest documented waterborne disease outbreak in US history, affecting over 400,000 people in Milwaukee in 1993! Bacterial zoonotic pathogens include Campylobacter from chickens, pathogenic E. coli from cattle (especially calves) and Salmonella from pet turtles and frogs.  Rotavirus and hepatitis E virus from swine can also be transmitted to persons through inadequately or untreated waters.  CDC maintains a list of diseases that can be spread from pets to people, many of which can be waterborne or rely on water-based vectors such as mosquitoes.

Preventing Zoonotic Diseases

It’s important to be aware of the different ways zoonotic diseases are transmitted to people, including:

  • Contact with the feces, saliva (such as when your dog licks your face or hands), blood and urine of an infected animal
  • Being bitten by an infected tick or mosquito
  • Consuming something unsafe, such as untreated water from a stream, undercooked meat or unwashed fruits and vegetables that are contaminated with feces from an infected person or animal

Source: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5805a3.htm

It’s also important to consider that some people are more at risk from developing serious or even life-threatening infections from zoonotic pathogens than others, including children, pregnant women, elderly and immunocompromised persons, such as someone with HIV or a chemotherapy patient.

 Fortunately, there are many over-lapping ways you can protect yourself from zoonotic diseases:

  • Wash hands frequently and follow proper hygiene
  • Always wash hands after being around animals, including pets
  • Take measures to prevent mosquito and tick bites

So remember, all creatures great and small can carry and transmit disease-causing germs, but an ounce of prevention (and disinfectant or bug spray) and frequent hand-washing can go a long way.

Additional information on healthy pets and people is available from CDC:


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Stepping up Our Game against Zika Virus

“Ground zero” for the first likely cases of locally transmitted Zika virus in the US has been identified as a one-mile square patch in the Wynwood neighborhood north of downtown Miami.  The virus has not yet been found in local mosquitoes, but Florida Department of Health officials are aggressively implementing disease and environmental surveillance while city and county agencies conduct mosquito control measures.   These include ground level spraying of the “ground hugging,” mosquitoes (aerial spraying is less efficient and effective), treating storm drains and removing standing water in affected neighborhoods.  Blood donations from the affected region are being screened for the virus. In short, it’s “game on” for Zika virus prevention in Florida where I work as an environmental administrator.

CDC poster illustrates measures to protect against mosquito bites

Health Officials Working Together

The Florida Department of Health and the US Centers for Disease Control and Prevention (CDC) are partnering to keep the public advised on strategies to avoid the mosquito borne illness that might result in devastating health effects in newborns of infected mothers and other less well documented health effects in adults, such as Guillain-Barre Syndrome (see CDC webpage).

According to the World Health Organization, the female (biting) Aedes aegypti mosquito flies an average of only 400 meters in her lifetime, meaning that it is people, not mosquitoes that move the virus among widely spaced communities.

Until a vaccine is available, the essential measures to avoid contracting the Zika virus are to prevent mosquito bites and to ensure protection during sex in the event that a partner may be a Zika virus carrier.  Because 80 percent of people infected with Zika virus have no symptoms, condom use during sexual intercourse is especially critical for pregnant women or women who may become pregnant.  CDC also recommends that women who are pregnant or who are planning to become pregnant postpone travel to areas with widespread Zika infection (see CDC webpage on Zika and Sexual Transmission).  That now includes the impacted area of Florida’s Wynwood neighborhood.

Drain and Cover

The Florida Department of Health’s “Drain and Cover” program provides the following tips to control the risk of mosquito borne illness:

  • Drain water from garbage cans, house gutters, pool covers, coolers, toys, flower pots, or any other containers where sprinkler or rain water has collected.
  • Discard old tires, drums, bottles, cans, pots and pans, broken appliances and other items that aren’t being used.
  • Empty and clean birdbaths and pets’ water bowls at least once or twice per week.
  • Protect boats and vehicles from rain with tarps that do not accumulate water.
  • Maintain appropriate pool chemistry of swimming pools. Empty plastic swimming pools when not in use.
  • Repair broken screens on windows, doors, porches and patios.
  • If you must be outside when Aedes mosquitoes are active (daytime), cover up. Wear shoes, socks, long pants and long sleeves.
  • Apply mosquito repellent to bare skin and clothing. Follow label directions. Repellents with DEET, picaridin, oil of lemon eucalyptus, para-menthane-diol, and IR3535 are effective and safe for pregnant and breast-feeding women, when used as directed. Use netting instead of repellents to protect children younger than two months.

Looking Ahead

If the recent outbreaks of dengue and chikungunya— which are also spread by the Aedes mosquito — are any indication, then it is expected that Florida will experience only small and geographically limited outbreaks of Zika.  That said, CDC notes regions once affected by dengue and chikungunya are considered to be a higher risk for Zika virus outbreaks.  The Florida Department of Health is committed to employ every available resource in order to reduce the spread of Zika virus.  Yes, it’s “game on” for Zika virus prevention in Florida.

The Florida Department of Health issues frequent Zika virus updates at:


Bob G. Vincent is an Environmental Administrator in the Florida Department of Health (and a helava nice guy). He manages Department of Health programs for Healthy Marine Beaches, Safe Drinking Water, Water Well Surveillance and Public Pools and Bathing Places.

Click here to download this article.


Unusual Uses for Chlorine Bleach
Written by A guest article by Dominique M. Williams

I have had the privilege of spending the last four years of my life on one of the most beautiful college campuses in Maryland. Everything I ever needed was within a short walking distance of my dorm room—the dining hall, library, mailroom, and student center, you name it! Yet even with all of these nearby resources, I spent most of my time in my room doing homework. This is the classic scenario for any undergraduate science major. Living in a building with more than 100 fellow students, the laundry room instantly became the most in-demand place in the entire residence hall. Keeping that in mind, I always ensured that I stocked up on two items each semester: detergent and bleach.

Bleach, chemically referred to as an aqueous solution of sodium hypochlorite (NaOCl), is one of the most common household chemicals used across the United States. Bleach is primarily used to whiten and brighten clothes, but there are other surprising uses! For starters, bleach is also used to remove certain stains and disinfect surfaces contaminated with pathogens. But what are some of the really unusual uses of bleach?

Cleaning Seashells

One of the most beautiful and memorable souvenirs you can take away from any sandy beach is a seashell. Most beachgoers will simply take the seashells home and place them on a dresser or into storage without completing one fundamental task—cleaning them! One pungent reminder is the awful odor they often carry.

While in the sea, mollusks absorb and process the minerals surrounding them, secreting calcium carbonate (CaCO3). The calcium carbonate forms an outer shell on the outside of their bodies, which continues to expand as the mollusk grows. When mollusks die, their shells are abandoned to the sea, many of which eventually appear on the beaches we frequent throughout the year. Knowing that sea creatures formerly lived in these shells should serve as a reminder to clean them promptly, and bleach is up to the task. According to Seashells.org, empty shells should be soaked in a 50-50 solution of water and bleach until the periostracum, the thin outer layer of skin, has disintegrated.

Flower Power

My family has a flower garden that sits next to the front door. When the garden is vacant, I enter the house through the garage. When the garden is in full bloom, I enter through the front door just so I can see the flowers.

Flowers possess everything they need in their natural habitat.  They collect nutrients from the soil through their roots. They absorb water through the roots, pushing the water up to the leaves via a specialized plant cell system called the xylem. The leaves are also responsible for providing the major source of food. Through photosynthesis and chlorophyll (the green pigment found in the leaves), plants use energy from sunlight to convert carbon dioxide (CO2) from the atmosphere and water into carbohydrates and oxygen.

When transferring flowers from soil to a vase, they are separated from their source of sustenance. While filling a vase with water and food additives serves as an effective substitute, cut flowers are still limited in their ability to receive essential nutrients, and are even more susceptible to wilting. But, the disinfecting power of bleach proves to be a suitable solution for this issue. Joan Rose, PhD, of the Water Quality & Health Council, suggests adding ¼ teaspoon of chlorine bleach to each quart of water in the vase. The addition of bleach preserves the clarity of the water and protects the flowers by destroying the bacteria that cause wilting. Although too much bleach will kill the flowers, a small amount is just enough to keep them in bloom for a long time!

Light The Way!

Bleach is not only used to lighten clothing, but homes as well! One fateful day in 2002, Brazilian mechanic Alfred Moser and his wife suffered through a citywide blackout. Although they experienced blackouts regularly, this time Moser decided to combat this power outage with his own man-made light, inspired by some advice from his boss. Mr. Moser successfully illuminated his home using only a plastic water bottle filled with water, a small amount of bleach, and sunlight! After the bottle was mostly filled with water, Moser added two capfuls of bleach and sealed it with a black cap. Next, Mr. Moser drilled a hole in one of his roof tiles, pushed the filled water bottle through, and applied polyester resin to prevent leakage.

When the sunlight strikes the bottle, it immediately illuminates the room below due to refraction of light. The addition of bleach prevents the water from turning green with algae when exposed to sunlight. It also prevents the water from clouding by destroying the microorganisms that could potentially reproduce inside of the bottle. Both the bleach and water must be replaced every five years in order to maintain its continuous use. Owners and renters of unlit homes across Brazil and other developing countries never have to worry about living in the dark again—at least during the daytime.

For a common household item, bleach sure has some interesting and peculiar uses, yet all three have proven to be extremely useful! Now, I wonder if detergent is good for anything else too….

Dominique Williams is a 2016 summer intern for the American Chemistry Council Chlorine Chemistry Division. Dominique is a senior chemistry major at Stevenson University in Owings Mills, Maryland.

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Sepsis Explained

Sepsis is the body’s overwhelming and life-threatening response to infection. Sepsis causes inflammation throughout the body, which can lead to tissue damage, organ failure, and even death, according to the Centers for Disease Control and Prevention (CDC). Sepsis is a serious complication of septicemia, also known as bacteremia or blood poisoning. Septicemia occurs when a bacterial infection somewhere in the body (e.g., the skin, kidneys, urinary tract, abdominal area or lungs) spreads into the bloodstream.

We recently wrote about human Vibrio infections from contaminated shellfish and coastal and especially brackish waters. Some Vibrio infections progress to sepsis, which is why we highlighted the Louisiana Department of Wildlife and Fisheries advisory that fishermen in saltwater carry with them “basic disinfectant (chlorine bleach mixed one part bleach to four parts fresh water1 or tincture of iodine, or antibiotic ointment) and use if skin is punctured while handling fishing tackle, bait or fish.”

According to the Mayo Clinic website, sepsis is diagnosed when at least two of the following signs accompany a probable or confirmed infection:

  • Elevated body temperature of 101 degrees F (or greater) or a below normal body temperature of 8 degrees F (or less)
  • Heart rate higher than 90 beats per minute
  • Respiratory rate higher than 20 breaths per minute.

Severe sepsis is diagnosed with at least one more of the following, which indicate an organ may be failing:

  • Significantly decreased urine output
  • Abrupt change in mental status
  • Decrease in platelet count
  • Difficulty breathing
  • Abnormal heart pumping function
  • Abdominal pain

Toxins released into the bloodstream by some bacteria can cause extremely low blood pressure. Septic shock results when the patient does not respond to simple fluid replacement. Septic shock can lead to death. Whereas most people recover from mild sepsis, the Mayo Clinic website indicates a 50 percent mortality rate for septic shock. The image above, from the CDC Sepsis Fact Sheet, lists major strategies for preventing sepsis.

Who is Vulnerable to Sepsis?

Anyone can develop septicemia and sepsis, but according to the Mayo Clinic the most vulnerable include the very young and very old; patients taking immunosuppressive medications; cancer patients; long-term steroid users; people with long-standing diabetes, AIDS or cirrhosis; people with large burns or severe injuries; and people with infections, such as pneumonia, meningitis, cellulitis and urinary tract infections.

Sepsis Requires Treatment!

Sepsis is a medical emergency that requires treatment. There are more than one million cases of sepsis each year in the US. Sepsis can lead to septic shock and death; survivors of sepsis may suffer permanent organ damage and have to deal with life-changing health effects.

The CDC recommends calling your doctor or going to the emergency room immediately if you have any signs or symptoms of an infection or sepsis. CDC urges that you state, “I AM CONCERNED ABOUT SEPSIS” to ensure timely evaluation and treatment, which may include antibiotics, oxygen and intravenous fluids. The image below from the CDC Sepsis Fact Sheet may be helpful in determining when to seek medical attention. Forewarned is forearmed!


For more information on sepsis, please see www.cdc.gov/sepsis.

Barbara M. Soule, R.N. MPA, CIC, FSHEA is an Infection Preventionist and a member of the Water Quality & Health Council. Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official.

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1 Fishermen should prepare this solution daily, as bleach solutions weaken over time.


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